title: Colonic diverticulitis in young Asians: a predominantly mild and right-sided disease.
abstract: BACKGROUND
  The management of diverticulitis in young Asian patients remains challenging. This study aimed to highlight the issues of managing diverticulitis in young Asians.
  
  
  METHODS
  A retrospective review of all patients who were admitted for acute colonic diverticulitis from October 2003 to December 2008 was performed. Patients who were ≤50 year old were considered 'young' and formed the study group.
  
  
  RESULTS
  The study group consisted of 142 patients. The majority (n = 126, 88.7%) had right-sided diverticulitis and most (n = 117, 82.4%) were mild in severity. Most of the patients who underwent emergency surgery were for suspected appendicitis (39/56, 69.6%). When we compared between those aged ≤50 and >50 years, the older group had worse diverticulitis (odds ratio (OR), 4.90, 95% confidence interval (CI), 2.00-11.99), been operated for indications other than suspected appendicitis (OR, 13.08, 95% CI, 5.42-31.56) and undergone a colectomy (OR, 9.96, 95% CI, 4.12-24.10). The younger group had a much higher incidence of right-sided disease (OR: 7.80, 95% CI: 4.32-14.07). Over a median follow-up of 40 (6-90) months, 7 (4.9%) patients were readmitted for a total of eight times for recurrent attacks of diverticulitis and all were successfully treated conservatively. Five other patients underwent elective surgery for persistent symptoms.
  
  
  CONCLUSIONS
  Diverticulitis in young Asians is often right-sided and mild in severity. A significant proportion is only diagnosed when operated for presumed appendicitis. Recurrent attacks are uncommon and can often be treated non-surgically.
authors.affiliation: Division of Colorectal Surgery, University Surgical Cluster, National University Health System, Singapore.
authors.forename: Ker-Kan
authors.initials: KK
authors.lastname: Tan
authors.forename: Jiayi
authors.initials: J
authors.lastname: Wong
authors.forename: Zhiyan
authors.initials: Z
authors.lastname: Yan
authors.forename: Choon-Seng
authors.initials: CS
authors.lastname: Chong
authors.forename: Jody Z
authors.initials: JZ
authors.lastname: Liu
authors.forename: Richard
authors.initials: R
authors.lastname: Sim
mesh_terms: D000293:Adolescent; D000328:Adult; D044466:Asian People; D004239:Diverticulitis, Colonic / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D012189:Retrospective Studies; D012720:Severity of Illness Index; D055815:Young Adult
keywords: Asians; diverticulitis; management; young